More than 200 local law enforcement agents made arrests, executed warrants and seized dozens of bank accounts and property on Feb. 20 in the largest health care anti-fraud operation in the history of Washington, D.C.

The crackdown came after a multi-year, multi-agency investigation into tens of millions of dollars in fraudulent Medicaid billing conducted by the FBI, the U.S. Department of Health and Human Services’ Office of Inspector General, the U.S. Secret Service, the Medicaid Fraud Control Unit of the District of Columbia’s Office of the Inspector General, the IRS, the U.S. Immigration and Customs Enforcement and other federal and local agencies.

“Today’s arrests are part of a well-coordinated action with our law enforcement partners that puts criminals on notice that we are actively working to identify, arrest and prosecute anyone who participates in defrauding government programs designed to assist truly deserving patients,” Valerie Parlave, assistant director in charge of the FBI’s Washington Field Office, said according to statements provided by the U.S. Attorney’s Office for the District of Columbia.

More than 20 people, including operators of home care agencies and nurse staffing agencies, office workers, and personal care assistants, were arrested for their alleged involvement in separate schemes involving fraud, kickbacks, and false billings in the growing field of home care services for D.C. Medicaid patients.

All four home health agencies involved in the indictments—Global Health Care Services, Ultra International, Vizion One and American Quality—had been previously marked for suspicious billing patterns by the D.C. Department of Health Care Finance and referred to the Medicaid Fraud Control Unit within the Office of the Inspector General beginning in 2009.

“[The D.C. Department] highlighted the agency’s growing concern with the unexplained and rapidly increasing cost of the personal care program in 2011 and has been working on a number of initiatives to address this serious problem since that time,” department Director Wayne Turnage said in a statement. “The actions by federal officials today will be of tremendous assistance as we move forward with additional reforms to the personal care program.”

One key indictment charges Florence Bikundi, 51, the owner of three home care agencies, for allegedly bilking D.C. and Maryland governments of $78 million in Medicaid payments, though she had been barred from participating in any federal health care programs. The Bowie, Md. resident, also known as Florence Ngwe and Florence Igwacho, allegedly concealed her past—which included revoked nursing licenses in Virginia, South Carolina and the District of Columbia—to obtain new Medicaid provider numbers for her businesses, Global Healthcare Inc., and Flo-Diamond Inc.

Bikundi is also charged with multiple counts of money laundering for the means by which she attempted to conceal the “nature, source, and location” of her misbegotten gains.

In other alleged schemes, defendants recruited and coached Medicaid beneficiaries to misrepresent their state of health to medical practitioners so they could qualify for home health care. Those patients then supposedly received cash payments of approximately $200 every two weeks to sign false timesheets for home care services that were not provided.

In another alleged racket, Adoshia L. Flythe, a 36-year-old home care aide from Washington, D.C., was accused of selling counterfeit home health care aide certificates to individuals, making them eligible for Medicaid reimbursement.

“This investigation has revealed that Medicaid fraud in the District of Columbia is at epidemic levels,” U.S. Attorney Ron Machen said in a statement. “This fraud diverts precious taxpayer dollars, drives up the cost of health care, and jeopardizes the strength of a program that serves the most vulnerable members of our society. However, as today’s arrests, searches, and seizures demonstrate, we are aggressively fighting back to protect the U.S. taxpayer and the integrity of our federal health care programs.”

The cases are being prosecuted by Special Assistant U.S. Attorney Dangkhoa Nguyen and Assistant U.S. Attorneys Ted Radway, Michael Friedman, and David Johnson, the office’s health care fraud coordinator, all of the Fraud and Public Corruption Section, and Assistant U.S. Attorney Anthony Saler of the Asset Forfeiture and Money Laundering Section.

The FBI has set up a hotline number to report suspected incidents of Medicaid fraud at 855-281-1242. Individuals can also provide information by e-mail toHealthCareFraud@ic.fbi.gov. The Department of Health and Human Services also has a hotline that can be reached at 800-HHS-TIPS or by visiting the agency’s website at http://oig.hhs.gov/ and clicking on the “Report Fraud” tab.